{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T10:01:55Z","timestamp":1789034515964,"version":"build-2803163510"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>The aim of this study was to study the presentation and management of children with symptomatic \u201cumbilical remnants\u201d (SUmR) and the efficacy of ultrasound (US) in diagnosis and predicting a need for surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This study included 65 children aged 2 months\u201312 years with clinical findings suggestive of umbilical remnants (UmR): umbilical granuloma (UG); umbilical polyp or prolapsing mucosa, periumbilical inflammation\/mass, or persistent umbilical discharge. Investigations included US and bacteriological culture-sensitivity tests of umbilical discharge. UG and umbilical polyps were excised. Minilaparotomy was performed for other SUmR and UG\/umbilical polyps where US suggested intra-abdominal pathology. The excised UmR tissue underwent histopathologic examination (HPE) for final diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There were 40 males and 25 females, with a median age of 6 months. The three groups after final diagnosis were (i) UG (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 38), (ii) vitellointestinal (VI) remnants (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 21), umbilical polyp (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 17), patent VI duct (PVID) (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 3), and umbilical cyst (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 1), and (iii) urachal remnants (UR) (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 6), urachal cysts (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 3) and patent urachus (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 3). Forty-nine UG\/umbilical polyps underwent simple excision. Sixteen (24.6%) patients underwent minilaparotomy, and in seven, US findings correlated with operative findings. US was false positive for intra-abdominal pathology in six cases (UG = 3; umbilical polyp = 3) and false negative in PVID (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 3). UG and umbilical polyps were differentiated only by HPE. There were no complications or recurrence. On grouping by presentation, US as a diagnostic modality in UG\/umbilical polyp had a specificity of 85% with a diagnostic accuracy of 89.09%. In UR, the figures were sensitivity 100%, specificity 0%, positive predictive value (PPV) 100%, negative predictive value (NPV) 0%, and diagnostic accuracy 100%. For VID remnants excluding umbilical polyps, the sensitivity was 25%, specificity 0%, PPV 100%, NPV 0%, and diagnostic accuracy 25%. Overall, the sensitivity of abdominopelvic US as a diagnostic modality in SUmR was 70%, specificity 89%, PPV 53%, and NPV 94% with overall diagnostic accuracy of 84%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>SUmR is most commonly UG or umbilical polyp and could not be differentiated on clinical grounds alone. In suspected urachal anomalies\/UR, US is an effective diagnostic modality. Overall, however, US has relatively low sensitivity and a low PPV and should be regarded as an accessory rather than a very effective diagnostic modality in SUmR. One-stage excision of SUmR is safe and effective. HPE of the excised SUmR is essential for the final diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jiaps.jiaps_181_24","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T06:04:46Z","timestamp":1736316286000},"page":"200-207","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["A Study of Symptomatic Umbilical Remnants in Children with Evaluation of the Role of Ultrasound as a Diagnostic Modality"],"prefix":"10.4103","volume":"30","author":[{"given":"Rohit Bhashkar","family":"Meshram","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children\u2019s Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashitosh D.","family":"Pokharkar","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children\u2019s Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Lakshmilekiya","sequence":"additional","affiliation":[{"name":"Department of Radiology, Lady Hardinge Medical College and Kalawati Saran Children\u2019s Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi Shankar","family":"Solanki","sequence":"additional","affiliation":[{"name":"Department of Pathology, Lady Hardinge Medical College and Kalawati Saran Children\u2019s Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children\u2019s Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Partap Singh","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of 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